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Bundled PCI Services in a Non-Hospital Cath Lab: Environmental Scan/Annotated Bibliography
Bundled PCI Services in a Non-Hospital Cath Lab: Environmental Scan/Annotated Bibliography The research questions guiding the environmental scan and the search strategy are described in detail in the attached appendix. The components of the annotated bibliography below (with links and citations to sources) are grouped into topic areas with main points relevant to the proposal review outlined below. BRIEF DESCRIPTION OF THE PROPOSAL The “Bundled PCI Services in a Non-Hospital Cath Lab” proposal aims to reduce costs of Percutaneous Coronary Interventions (PCIs) by giving Medicare patients the option to have the procedure performed in a non-hospital outpatient cardiac catheterization (cath) lab. Clearwater Cardiovascular Consultants, the submitting organization, proposes Bundled PCI services to allow qualified non-hospital cath labs the ability to perform PCIs, beginning with CCC’s own established cath lab as a limited scale test case to develop appropriate criteria, with expansion to at least two additional cath labs in the next year. SUBMITTING ORGANIZATION Clearwater Cardiovascular Consultants Clearwater Cardiovascular Consultants (CCC) is a cardiovascular medicine group founded in 1975, located in Clearwater, Florida, and comprised of 20+ physicians. Prior to 2016, CCC physicians provided PCI services at a hospital outpatient cardiac cath lab owned by Morton Plant Hospital (MPH), located near the emergency room/hospital outpatient lab. On January 1, 2016, CCC acquired this cath lab from MPH, retaining the same staff. http://www.ccicheart.com/ https://baycare.org/mph Bundled PCI Services in a Non-Hospital Cath Lab, June 2018 1 CURRENT ISSUES AND CONCERNS WITH MEDICARE PAYMENT FOR PCI CCC proposes an approach that will reduce spending for Anchor PCI procedures by an estimated $1,285 for a single vessel PCI and $3,105 for a multi-vessel PCI by performing PCIs in more cost-effective facilities as appropriate. -
View a List of the 2021 Performance Achievement Award Recipients
Congratulations to the Recipients of the Rewarding Excellence. Driving Success. The Chest Pain – MI Registry Performance Achievement Award recognizes a hospital’s success in implementing Chest Pain – MI Registry™ a higher standard of care for heart attack patients by meeting aggressive performance measures. 2021 Performance Achievement Award View hospitals participating in the registry at CardioSmart.org/ChestPainMI. St. Francis Medical Center Lee’s Summit Medical Center Summa Health Ascension Seton Medical Center Hays St. Luke’s Hospital Christian Hospital BJC Healthcare JFK Medical Center Baylor Scott & White Heart and Colorado Springs, CO Lee’s Summit, MO Akron, OH Cedar Rapids, IA St. Louis, MO Edison, NJ Vascular – Dallas Kyle, TX Dallas, TX 2021 The George Washington University Hospital SSM Health Saint Louis University Hospital Summa Health 2021 Trinity Medical Center – Bettendorf Citizens Memorial Hospital Ocean Medical Center Washington, DC St. Louis, MO Barberton, OH Dell Seton Medical Center at Bettendorf, IA Bolivar, MO Brick, NJ Baylor Scott & White Medical Center The University of Texas AdventHealth Celebration SSM Health St. Mary’s Hospital – The University of Toledo Medical Center Trinity Regional Medical Center Cox Medical Center Branson Riverview Medical Center – Round Rock Austin, TX Round Rock, TX Kissimmee, FL Jefferson City Toledo, OH Ft. Dodge, IA Branson, MO Red Bank, NJ Jefferson City, MO Houston Methodist The Woodlands Hospital CHRISTUS Mother Frances Hospital Chest Pain – MI Hamilton Medical Center Ascension -
Transcatheter Mitral and Pulmonary Valve Therapy
Journal of the American College of Cardiology Vol. 53, No. 20, 2009 © 2009 by the American College of Cardiology Foundation ISSN 0735-1097/09/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2008.12.067 FOCUS ISSUE: VALVULAR HEART DISEASE Transcatheter Mitral and Pulmonary Valve Therapy Nicolo Piazza, MD,* Anita Asgar, MD,† Reda Ibrahim, MD,‡ Raoul Bonan, MD‡ Rotterdam, the Netherlands; London, United Kingdom; and Montreal, Quebec, Canada As the percentage of seniors continues to rise in many populations around the world, the already challenging burden of valvular heart disease will become even greater. Unfortunately, a significant proportion of patients with moderate-to-severe valve disease are refused or denied valve surgery based on age and/or accompanying comorbidities. Furthermore, because of advances in pediatric cardiology, the number of adult patients with con- genital heart disease is on the rise and over time, these patients will likely require repeat high-risk surgical pro- cedures. The aim of transcatheter valve therapies is to provide a minimally invasive treatment that is at least as effective as conventional valve surgery and is associated with less morbidity and mortality. The objective of this review was to provide an update on the clinical status, applicability, and limitations of transcatheter mitral and pulmonary valve therapies. (J Am Coll Cardiol 2009;53:1837–51) © 2009 by the American College of Cardiology Foundation The prevalence of moderate-to-severe valvular heart disease ing prevalence of adults with congenital heart disease. It is is highly age-dependent, ranging from an estimated 0.7% in safe to assume that some of these patients will require 18- to 44-year-olds in the U.S. -
Curriculum in Interventional Cardiology
CURRICULUM IN INTERVENTIONAL CARDIOLOGY Educational Goals The educational goals of this program are to train fellows in a specialized cardiovascular disease area requiring technical, educational and research skills involved in interventional cardiology. The knowledge base for interventional cardiology has become increasingly well-defined as a result of unparalleled programs in basic and clinical research in atherosclerosis, coronary disease, cardiomyopathy and valvular heart disease. Our educational goals for training in interventional cardiology are aligned with and guided by the recommendations of the ACC/SCAI/ AHA task force on optimal adult interventional cardiology training programs as follows: • To understand the effectiveness and limitations of coronary interventional procedures in order to select patients and procedure types appropriately. • To achieve the appropriate cognitive knowledge and technical skills needed to perform interventional cardiac procedures at the level of quality attainable through the present state of the art. • To foster an attitude of life-long learning and critical thinking skills needed to gain from experience and incorporate new developments. • To understand and commit to quality assessment and improvement in procedure performance. All trainees must be skilled in obtaining a history and physical examination of the cardiovascular system, specifically as it relates to the performance of procedures, management of the patient during the procedure and also post-procedural follow-up. All trainees must be familiar with the role of aging and psychogenic factors in the production of symptoms, as well as emotional and physical response of the patient to cardiovascular disease. In addition, trainees must be familiar with specific pathophysiology as it relates to the development of cardiovascular disease particularly that of acute coronary syndromes and their management in the cardiac catheterization laboratory. -
(12) United States Patent (10) Patent No.: US 8,187,323 B2 Mortier Et Al
USOO8187323B2 (12) United States Patent (10) Patent No.: US 8,187,323 B2 Mortier et al. (45) Date of Patent: May 29, 2012 (54) VALVE TO MYOCARDIUM TENSION 4,372,293 A 2/1983 Vijil-Rosales MEMBERS DEVICE AND METHOD 4.409,974 A 10, 1983 Freedland 4,536,893 A 8, 1985 Parravicini 4,690,134 A 9/1987 Snyders (75) Inventors: Todd J. Mortier, Minneapolis, MN 4,705,040 A 1 1/1987 Mueller et al. (US); Cyril J. Schweich, Jr., St. Paul, 4,936,857 A 6, 1990 Kulik MN (US) 4,944,753. A 7/1990 Burgess et al. 4,960,424 A 10, 1990 Grooters (73) Assignee: Edwards Lifesciences, LLC, Irvine, CA 4,997.431 A 3, 1991 Isner et al. US 5,104,407 A 4, 1992 Lam et al. (US) 5,106,386 A 4, 1992 Isner et al. 5,131,905 A 7, 1992 Grooters (*) Notice: Subject to any disclaimer, the term of this RE34,021 E 8, 1992 Mueller et al. patent is extended or adjusted under 35 5,169,381 A 12/1992 Snyders U.S.C. 154(b) by 205 days. (Continued) (21) Appl. No.: 09/981,790 FOREIGN PATENT DOCUMENTS (22) Filed: Oct. 19, 2001 DE 36 14292 c 111987 (Continued) (65) Prior Publication Data OTHER PUBLICATIONS US 20O2/OO2908O A1 Mar. 7, 2002 Dickstein et al., “Heart Reduction Surgery: An Analysis of the Impact Related U.S. Application Data on Cardiac Function.” The Journal of Thoracic and Cardiovascular (63) Continuation of application No. 08/992.316, filed on Surgery, vol. -
Catheterization Lab Patient Instructions Catheterization Lab (520) 324-5034 Inside Front Cover Catheterization Lab Patient Instructions
Catheterization Lab Patient Instructions Catheterization Lab (520) 324-5034 Inside Front Cover Catheterization Lab Patient Instructions Catheterization Lab (520) 324.5034 5301 E. Grant Road, Tucson, AZ 85712 Table of Contents: Catheterization Lab Patient Instructions The day before your procedure ........................... 1 Medications ............................................ 1 What to bring with you to the hospital ....................... 1 When you arrive at the hospital .......................... 2 Preparing for your procedure .............................. 3 During your procedure .................................. 4 After your procedure .................................... 4 Before you are discharged ............................... 5 After your release ....................................... 5 Activity restrictions after heart catheterization. .6 Things to keep in mind .................................. 6 Cath Lab/Special Procedures Pre-Procedural Medication Instructions Diabetes medication ..................................... 7 Other medications .................................... 9 Catheterization Lab Patient Instructions The day before your procedure • Do not eat or drink anything 8 hours prior to procedure. However, it is okay to have a small sip of water with your medications. • You must have a responsible adult drive you home if you are having any type of sedation or anesthesia. • Take a shower either the night before, or the morning of your procedure. • Inform your doctor if you are unable to lie flat on your back for -
Clinical Significance of Aortopulmonary Collaterals After Arterial Switch Operation in Neonates with D-Transposition of the Great Arteries
Clinical significance of aortopulmonary collaterals after arterial switch operation in neonates with d-transposition of the great arteries Navarini S. (1,4), Balmer C. (1,4), Hug M. (2,4), Dave H. (3,4), Prêtre R. (3,4), Kretschmar O. (1,4), Knirsch W. (1,4) (1) Division of Pediatric Cardiology, (2) Division of Intensive Care/Neonatology, (3) Division of Congenital Cardiac Surgery, (4) Children’s Research Centre, University Children’s Hospital Zürich, Switzerland Background Conclusion In patients with d-transposition of great arteries (d-TGA), After arterial switch operation, nearly half of our patients enlarged bronchial arteries / major aortopulmonary (43%) needed a cardiac catheterisation and half of them collateral arteries (MAPCA) are common after surgical repair. (20%) showed hemodynamic relevant MAPCA’s. Those MAPCA’s are often clinically silent, but may cause 2 MAPCA’s were a risk factor for prolonged ICU and congestive heart failure after surgical repair with systemic hospital stay with a longer ventilation time, longer hypoxemia, pulmonary volume overload, left ventricular support with inotropic agents and delayed chest closure. dysfunction and respiratory failure. We suggest an early work-up in the cath lab when facing The aim of our study was to evaluate our patient population for an early postoperative complicated course due to complicated early postoperative course due to MAPCA’s. coronary anomaly or MAPCA’s. 3 Methods 4-year retrospective study at Division of Pediatric Cardiology, Universitiy Children’s Hospital , Zürich. Analysis of clinical data of neonates with simple d-TGA after arterial switch operation with known MAPCA’s complicating the postoperative course. -
Index of Microcirculatory Resistance: the Basics
Index of Microcirculatory Resistance: The Basics William F. Fearon, MD Associate Professor of Medicine Director, Interventional Cardiology Stanford University Medical Center Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement or affiliation with the organization(s) listed below. Affiliation/Financial Relationship Company Grant/Research Support St. Jude Medical, Medtronic, NHLBI Consulting Fees/Honoraria Medtronic Major Stock Shareholder/Equity Royalty Income Ownership/Founder Intellectual Property Rights Other Financial Benefit Minor stock options: HeartFlow Assessment of the Microvasculature Diagnostic Challenge Epicardial CAD Lanza and Crea. Circulation 2010;121:2317-2325. Assessment of the Microvasculature Diagnostic Challenge Epicardial CAD Microvascular Dysfunction Lanza and Crea. Circulation 2010;121:2317-2325. Assessment of the Microvasculature Extremely challenging diagnosis Heterogeneous patient population Variety of pathogenetic mechanisms Poor anatomic resolution Potentially patchy nature of the disease Therefore, assessment of the microvasculature is primarily functional and not anatomic Evaluating the Microcirculation… …in the Cath Lab TIMI Myocardial Perfusion Grade: Evaluating the Microcirculation… …in the Cath Lab TIMI Myocardial Perfusion Grade: Easy to obtain Specific for microvasculature Predictive of outcomes in large studies Drawbacks: Qualitative Interobserver variability Not as useful in smaller studies Doppler Wire -
Heart Valve Surgery Factsheet
Heart information Heart valve surgery Contents Page 1 What are heart valves? Page 3 What is heart valve surgery? Page 3 Valve repair Page 4 Valve replacement Page 4 What happens during heart valve surgery? Page 5 Why do I need heart valve surgery? Page 6 What will happen after heart valve surgery? Page 6 Will I feel pain after the operation? Page 6 How long will I have to stay in hospital? Page 7 How long will it take to recover from heart valve surgery? Page 7 When can I start eating again? Page 8 What should I be eating? Page 8 What if I am constipated? Page 8 How active can I be? Page 9 When can I be more physically active? Page 9 When can I have sex? Page 10 Why am I so tired? Page 10 Why do I feel great one day, but dreadful the next? Page 10 When can I return to work? Page 10 Palpitations Page 11 Heart attack Page 12 Endocarditis Page 12 Will I need to take medicine? Page 13 Important things to remember about anti-coagulant medicine Page 14 Warfarin and food Page 15 What should I talk to my doctor about? Page 16 Glossary What are heart valves? For more Heart valves are like one-way doors that control the direction of blood flow between the four chambers of the heart. There are information two upper chambers (the atria) and two lower chambers (the on this topic ventricles) (see the diagram on page 2). The atria receive blood please call from the body and pump it into the ventricles. -
Medicare National Coverage Determinations Manual, Part 1
Medicare National Coverage Determinations Manual Chapter 1, Part 1 (Sections 10 – 80.12) Coverage Determinations Table of Contents (Rev. 10838, 06-08-21) Transmittals for Chapter 1, Part 1 Foreword - Purpose for National Coverage Determinations (NCD) Manual 10 - Anesthesia and Pain Management 10.1 - Use of Visual Tests Prior to and General Anesthesia During Cataract Surgery 10.2 - Transcutaneous Electrical Nerve Stimulation (TENS) for Acute Post- Operative Pain 10.3 - Inpatient Hospital Pain Rehabilitation Programs 10.4 - Outpatient Hospital Pain Rehabilitation Programs 10.5 - Autogenous Epidural Blood Graft 10.6 - Anesthesia in Cardiac Pacemaker Surgery 20 - Cardiovascular System 20.1 - Vertebral Artery Surgery 20.2 - Extracranial - Intracranial (EC-IC) Arterial Bypass Surgery 20.3 - Thoracic Duct Drainage (TDD) in Renal Transplants 20.4 – Implantable Cardioverter Defibrillators (ICDs) 20.5 - Extracorporeal Immunoadsorption (ECI) Using Protein A Columns 20.6 - Transmyocardial Revascularization (TMR) 20.7 - Percutaneous Transluminal Angioplasty (PTA) (Various Effective Dates Below) 20.8 - Cardiac Pacemakers (Various Effective Dates Below) 20.8.1 - Cardiac Pacemaker Evaluation Services 20.8.1.1 - Transtelephonic Monitoring of Cardiac Pacemakers 20.8.2 - Self-Contained Pacemaker Monitors 20.8.3 – Single Chamber and Dual Chamber Permanent Cardiac Pacemakers 20.8.4 Leadless Pacemakers 20.9 - Artificial Hearts And Related Devices – (Various Effective Dates Below) 20.9.1 - Ventricular Assist Devices (Various Effective Dates Below) 20.10 - Cardiac -
A Focus on Valve-Sparing Ascending Aortic Aneurysm Repair Newyork
ADVANCES IN CARDIOLOGY, INTERVENTIONAL CARDIOLOGY, AND CARDIOVASCULAR SURGERY Affiliated with Columbia University College of Physicians and Surgeons and Weill Cornell Medical College A Focus on Valve-Sparing NOVEMBER/DECEMBER 2014 Ascending Aortic Aneurysm Repair Emile A. Bacha, MD The most frequent location for aneurysms in the Chief, Division of Cardiac, chest occurs in the ascending aorta – and these Thoracic and Vascular Surgery aneurysms are often associated with either aortic NewYork-Presbyterian/Columbia stenosis or aortic insufficiency, especially when the University Medical Center aneurysm involves a bicuspid aortic valve. Director, Congenital and Pediatric Cardiac Surgery “We know that patients who have enlarged NewYork-Presbyterian Hospital aortas or aneurysms of the ascending aorta are at [email protected] great risk for one of two major life-threatening events: an aortic rupture or an aortic dissection,” Allan Schwartz, MD says Leonard N. Girardi, MD, Director of Chief, Division of Cardiology Thoracic Aortic Surgery in the Department of NewYork-Presbyterian/Columbia Cardiothoracic Surgery, NewYork-Presbyterian/ University Medical Center Weill Cornell Medical Center. “Dissection of the Valve-sparing ascending aortic aneurysm repair [email protected] inner lining of the wall of the blood vessel can also lead to rupture or other complications down last 15 years, the Aortic Surgery Program at Weill O. Wayne Isom, MD the line. For example, as the tear extends it may Cornell has been aggressively pursuing the devel- Cardiothoracic Surgeon-in-Chief NewYork-Presbyterian/ affect the vessels that supply the brain or the opment of a procedure that would enable surgeons Weill Cornell Medical Center coronary arteries or cause tremendous damage to to spare the patient’s native valve. -
Mitral Valvuloplasty
MITRAL VALVULOPLASTY Appointment Date: __________________________ WHAT TIME SHOULD I ARRIVE? The Heart Lab Staff will call you between 2 – 4 p.m. the day prior to your test with your arrival time. The approximate time of your procedure is not known until the day before your test. If you will not be available at that time to receive the call, or if you don’t get a call by 4 p.m., please call to confirm your arrival time. Heart Cath Lab: 330-363-4230 Ambulatory Cardiac Unit: 330-363-5016 (if no answer in Heart Lab) Please use the Bedford (6th Street) entrance on arrival to the hospital. The visitor lot on 6th Street (lot 3) is the closest parking INSTRUCTIONS: Please review the written information given to you prior to coming to the hospital. You will be scheduled for a pretest appointment for your pre-admission testing. Do not eat or drink anything except for sips of water with your medication(s) after 12 midnight the night before your procedure. Please bring all your medications to the hospital the day of your procedure. They will be sent home with you. You will not be permitted to take medications brought in from home while you are in the hospital. If you are allergic to shellfish, iodine or X-ray dye, please tell the staff. Other instructions________________________________________________ Medication Instructions: Your doctor office or nurse coordinator will give you instructions about what medications to take (or not take) before your procedure. LOCATION: Ambulatory Cardiac Unit, located in Aultman Heart and Vascular Center.